Basilar skull fracture
A basilar skull fracture is a break of a bone in the base of the skull. Symptoms may include bruising behind the ears, bruising around the eyes, or blood behind the ear drum. A cerebrospinal fluid (CSF) leak occurs in about 20% of cases and may result in fluid leaking from the nose or ear. Meningitis occurs in about 14% of cases. Other complications include injuries to the cranial nerves or blood vessels.
| Basilar skull fracture | |
|---|---|
| Other names | Basal skull fracture, skull base fractures |
| A subtle temporal bone fracture as seen on a CT scan | |
| Specialty | Emergency medicine, neurosurgery |
| Symptoms | Bruising behind the ears, bruising around the eyes, blood behind the ear drum |
| Complications | Cerebrospinal fluid leak, facial fracture, meningitis |
| Types | Anterior, central, posterior |
| Causes | Trauma |
| Diagnostic method | CT scan |
| Treatment | Based on injuries inside the skull |
| Frequency | ≈12% of severe head injuries |
A basilar skull fracture typically requires a significant degree of trauma to occur. It is defined as a fracture of one or more of the temporal, occipital, sphenoid, frontal or ethmoid bone. Basilar skull fractures are divided into anterior fossa, middle fossa and posterior fossa fractures. Facial fractures often also occur. Diagnosis is typically by CT scan.
Treatment is generally based on the extent and location of the injury to structures inside the head. Surgery may be performed to seal a CSF leak that does not stop, to relieve pressure on a cranial nerve or repair injury to a blood vessel. Prophylactic antibiotics do not provide a clinical benefit in preventing meningitis. A basilar skull fracture occurs in about 12% of people with a severe head injury.